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Self-Inserted Needles in the Heart
Marco Di Paolo1, Benedetta Guidi2, Giuseppe Vergaro3
1Section of Legal Medicine, University of Pisa, S. Chiara Hospital, Pisa, Italy.
The American Journal of Cardiology
|August 17, 2015
Summary
A rare case of self-inflicted cardiac injury presented as acute coronary syndrome. Autopsy revealed multiple metallic foreign bodies, highlighting the importance of considering unusual diagnoses in chest pain cases.
Area of Science:
- Cardiology
- Forensic Pathology
- Medical Imaging
Background:
- Penetrating cardiac injuries typically present with clear clinical signs.
- Misleading presentations can complicate the diagnosis of cardiac trauma.
Observation:
- A 38-year-old male presented with chest pain, elevated myocardial necrosis biomarkers, and ECG/echocardiogram changes suggestive of acute coronary syndrome.
- Despite initial workup for acute coronary syndrome, the patient experienced clinical deterioration and death.
Findings:
- Delayed chest radiography and subsequent autopsy revealed multiple metallic foreign bodies within the thorax.
- The patient had self-inserted cardiac lesions with a highly atypical clinical presentation.
Implications:
- This case underscores the necessity of considering non-ischemic etiologies, including self-inflicted foreign body injuries, in patients with chest pain and cardiac abnormalities.
- Diagnostic strategies for chest pain should remain broad, especially when clinical presentations are incongruent with initial findings.
- Autopsy remains crucial for identifying unexpected causes of death and clarifying complex medical cases.